Transvesical open prostatectomy versus transurethral resection of the prostate for the treatment of benign prostatic hyperplasia, Iraq: A retrospective study

Wishyar Al Bazzaz

doi:10.15218/zjms.2024.26

Authors

Wishyar Al Bazzaz Department of Urology, Rizgary Teaching Hospital, Ministry of Health, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2024.26

Keywords:

Benign, Prostatic hyper plasia, Prostatectomy, Transurethral

Abstract

Background and Objective: Surgical treatment is an effective option for symptomatic benign prostatic hyperplasia (BPH), after failed conservative therapy. Transurethral resection of the prostate (TURP) is considered as a standard treatment method for the management of the small to medium prostate while transvesical open prostatectomy (OP) is a standard option for great prostate. The objective of this study is to evaluate the efficacy and safety of both (B-TURP) and (OP).

Methods: The present study included 73 patients underwent either transvesical open prostatectomy (31 patients) or bipolar transurethral resection of the prostate (42 patients) between May 2019 to May 2021, in Erbil-city. The baseline characteristics, intraoperative and postoperative characteristics plus early and late adverse effects were obtained from medical records for all patients in both groups, retrospectively. The data analyzed and compared statistically.

Results: The baseline characteristics in the studied groups showed no significant differences except for the prostate size which was more on the OP group. According to the results, operative time was significantly (P <0.001) lower in the OP group. The means of the following variables in the OP group were significantly higher than those of the B-TURP group: Hospitalization days (P <0.001), days of catheter removal, back to normal activity (P <0.001), QoL score (P = 0.027), Qmax (P < 0.001), and PVR (P = 0.046), while no significant difference was detected regarding IPSS (P = 0.404).

Conclusion: B-TURP was superior to OP regarding the hospitalization days, recovery time back to normal day-activity, and quality of life. Otherwise, both mentioned approaches work well for the treating symptomatic BPH.

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References

Lokeshwar SD, Harper BT, Webb E, Jordan A, Dykes TA, Neal DE, et al. Epidemiology and treatment modalities for the management of benign prostatic hyperplasia. Transl Andro Uro 2019; 8(5):529. DOI: 10.21037/tau.2019.10.01

Devlin CM, Simms MS, Maitland NJJBi. Benign prostatic hyperplasia–what do we know? BJU Int 2021; 127(4):389–99. DOI: 10.1111/bju.15229

Vlotman-Novinuk DJJoPP. Treatment options for benign prostate enlargement. J Pres Pract 2019; 1(3):130–8. DOI: 10.12968/jprp.2019.1.3.130

Nagakura Y, Hayashi M, Kajioka SJPI. Lifestyle habits to prevent the development of benign prostatic hyperplasia: Analysis of Japanese nationwide datasets. Pro Int 2022. DOI:10.1016/j.prnil.2022.06.004

Carnevale FC, Moreira AM, de Assis AM, Antunes AA, Cristina de Paula Rodrigues V, Srougi M, et al. Prostatic artery embolization for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: 10 years’ experience. J Vas Int Rad 2020; 296(2):444–51. DOI: 10.1148/radiol.2020191249

Langan RC. Benign prostatic hyperplasia. Primary Care. Cli Off Pract 2019;46(2):223-32. DOI: 10.1016/j.pop.2019.02.003

Ofoha CG, Raphael JE, Dakum NK, Shu'aibu SI, Akhaine J, Yaki IMJPAMJ. Surgical management of benign prostate hyperplasia in Nigeria: open prostatectomy versus transurethral resection of the prostate. Pan Afr Med J 2021; 39(1). DOI: 10.11604/pamj.2021.39.165.24767

Zhang W, Cao G, Sun Y, Wu F, Wang Q, Xu T, et al. Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in middle-aged and older Chinese individuals: Results from the China Health and Retirement Longitudinal Study. J Aff Disorder 2022; 296:660–6. DOI: 10.1016/j.jad.2021.09.045

Ajayi A, Abraham KJAJoU. Understanding the role of estrogen in the development of benign prostatic hyperplasia. Afr J Urol 2018; 24(2):93–7. DOI: 10.1016/j.afju.2018.01.005

Kim EH, Brockman JA, Andriole GLJAjou. The use of 5-alpha reductase inhibitors in the treatment of benign prostatic hyperplasia. Asian J Urol 2018; 5(1):28–32. DOI: 10.1016/j.ajur.2017.11.005

Nettleton J, Jones P, Pietropaolo A, Geraghty R, Rai B, Drake M, et al. The industrial revolution for the management of benign prostate obstruction: worldwide publication trends for surgical and medical therapies over the past two decades. Cent European J Urol 2019; 72(2):149. DOI: 0.5173/ceju.2019.1876

Bauer SR, Harrison SL, Cawthon PM, Senders A, Kenfield SA, Suskind AM, et al. Longitudinal Changes in Adiposity and Lower Urinary Tract Symptoms Among Older Men. J Gerontol 2021. DOI: 10.1093/gerona/glab227

Fogaing C, Alsulihem A, Campeau L, Corcos JJM. Is early surgical treatment for benign prostatic hyperplasia preferable to prolonged medical therapy: pros and cons. Medicina 2021; 57(4):368. DOI: 10.3390/medicina57040368

Pisco JM, Bilhim T, Pinheiro LC, Fernandes L, Pereira J, Costa NV, et al. Medium-and long-term outcome of prostate artery embolization for patients with benign prostatic hyperplasia: results in 630 patients. J Vasc Interv Radiol 2016; 27(8):1115–22. DOI: 10.1016/j.jvir.2016.04.001

Man CW. Surgical option for benign prostatic hyperplasia (BPH). The Hong Kong Medical Diary 2011; 16(6):13–8.

Foster HE, Dahm P, Kohler TS, Lerner LB, Parsons JK, Wilt TJ, et al. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline Amendment 2019. J Urol 2019; 202(3):592–8. DOI: 10.1097/JU.0000000000000319

Dotzauer R, La Torre A, Thomas A, Brandt M, Böhm K, Mager R, et al. Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison. World J Urol 2021; 39(1):149–56. DOI: 10.1007/s00345-020-03168-1

Srinivasan A, Wang R. An update on minimally invasive surgery for benign prostatic hyperplasia: techniques, risks, and efficacy. World J Mens Health 2020; 38(4):402. DOI: 10.5534/wjmh.190076

Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 2013; 64(1):118–40. DOI: 10.1016/j.eururo.2013.03.004

Madersbacher S, Sampson N, Culig ZJG. Pathophysiology of benign prostatic hyperplasia and benign prostatic enlargement: a mini-review. Gerontology 2019; 65(5):458–64. DOI: 10.1159/000496289

Gravas S, Cornu J, Drake M, Gacci M, Gratzke C, Herrmann T. Management of non-neurogenic male lower urinary tract symptoms (LUTS). Guidlines 2018. 2020.

John H, Wagner C, Padevit C, Witt JJWJoU. From open simple to robotic-assisted simple prostatectomy (RASP) for large benign prostate hyperplasia: the time has come. World J Urol 2021; 39(7):2329–36. DOI: 10.1007/s00345-020-03508-1

Launer BM, McVary KT, Ricke WA, Lloyd GLJBi. The rising worldwide impact of benign prostatic hyperplasia. BJU Int 2021; 127(6):722-8. DOI: 10.1111/bju.15286

Ulchaker JC, Martinson MSJC, CEOR. Cost-effectiveness analysis of six therapies for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Clinicoecon Outcomes Res 2018; 10:29. DOI: 10.2147/CEOR.S148195

Park S, Ryu J-m, Lee M, editors. Quality of life in older adults with Benign Prostatic hyperplasia. Healthcare 2020: MDPI. DOI: 10.3390/healthcare8020158

Abou Zeinab M, Kaviani A, Ferguson E, Beksac AT, Schwen Z, Gill B, et al. Single-port transvesical versus open simple prostatectomy: a perioperative comparative study. Prostate Cancer Prostatic Dis 2022:1–5. DOI: 10.1038/s41391-022-00566-x

Babić U, Soldatović I, Vuković I, Dragićević S, Đorđević D, Aćimović M, et al. Impact of surgical treatment of benign prostate hyperplasia on lower urinary tract symptoms and quality of life. Vojnosanit Pregl 2019; 76(1):30–5. DOI: 10.2298/VSP170227062B

Lokeshwar SD, Valancy D, Lima TFN, Blachman-Braun R, Ramasamy RJ. A systematic review of reported ejaculatory dysfunction in clinical trials evaluating minimally invasive treatment modalities for BPH. Curr Urol Rep 2020; 21(12):1–10. DOI: 10.1007/s11934-020-01012-y

Ou R, You M, Tang P, Chen H, Deng X, Xie KJU. A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. Urology 2010; 76(4):958–61. DOI: 2010 Oct;76(4):958-61

Ene C, Geavlete P, Geavlete BJC. What’s New in Bipolar TURP for Surgical Management of BPH? Chirurgia 2020; 115(3):307–13. DOI: 10.21614/chirurgia.115.3.307

Wu Y, Pan H, Wang W-M, Xu D, Zhang L, Gu Z-Q, et al. A possible relationship between serum sex hormones and benign prostatic hyperplasia/lower urinary tract symptoms in men who underwent transurethral prostate resection. Asian J Androl 2017; 19(2):230. DOI: 10.4103/1008-682X.171575

Nnabugwu I, Ugwumba F, Udeh E, Ozoemena OJNJoCP. Learning transurethral resection of the prostate: A comparison of the weight of resected specimen to the weight of enucleated specimen in open prostatectomy. Niger J Clin Pract 2017; 20(12):1590–5. DOI: 10.4103/njcp.njcp_70_17

Ahyai SA, Chun FK, Lehrich K, Dahlem R, Zacharias MS, Fisch MM, et al. Transurethral holmium laser enucleation versus transurethral resection of the prostate and simple open prostatectomy—which procedure is faster? J Urol 2012; 187(5):1608–13. DOI: 10.1016/j.juro.2011.12.107

Liu F-C, Hua K-C, Lin J-R, Pang S-T, Yu H-PJM. Prostate resected weight and postoperative prostate cancer incidence after transurethral resection of the prostate: a population-based study. Medicine 2019; 98(3). DOI: 10.1097/MD.0000000000013897